113 results on '"Silvia Maffei"'
Search Results
2. Low Vitamin D Levels Are Associated with Increased Cardiac Iron Uptake in Beta-Thalassemia Major
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Antonella Meloni, Laura Pistoia, Cristina Vassalle, Anna Spasiano, Ilaria Fotzi, Sergio Bagnato, Maria Caterina Putti, Antonella Cossu, Francesco Massei, Piera Giovangrossi, Silvia Maffei, Vincenzo Positano, and Filippo Cademartiri
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thalassemia major ,myocardial iron overload ,vitamin D ,parathyroid hormone ,Medicine (General) ,R5-920 - Abstract
We evaluated the association of vitamin D and parathormone (PTH) levels with cardiac iron and function in beta-thalassemia major (β-TM) patients. Two-hundred and seventy-eight TM patients (39.04 ± 8.58 years, 56.8% females) underwent magnetic resonance imaging for the assessment of iron overload (T2* technique), biventricular function parameters (cine images), and replacement myocardial fibrosis (late gadolinium enhancement technique). Vitamin D levels were deficient (p < 0.0001). In TM, the periodic and regular assessment of vitamin D levels can be beneficial for the prevention of cardiac iron accumulation and subsequent overt dysfunction.
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- 2023
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3. Sex Differences in Repolarization Markers: Telemonitoring for Chronic Heart Failure Patients
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Federica Moscucci, Susanna Sciomer, Silvia Maffei, Antonella Meloni, Ilaria Lospinuso, Myriam Carnovale, Andrea Corrao, Ilaria Di Diego, Cristina Caltabiano, Martina Mezzadri, Anna Vittoria Mattioli, Sabina Gallina, Pietro Rossi, Damiano Magrì, and Gianfranco Piccirillo
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myocardial repolarization ,Tend ,sex differences ,chronic heart failure telemonitoring ,Medicine - Abstract
Aging and chronic heart failure (CHF) are responsible for the temporal inhomogeneity of the electrocardiogram (ECG) repolarization phase. Recently, some short period repolarization–dispersion parameters have been proposed as markers of acute decompensation and of mortality risk in CHF patients. Some important differences in repolarization between sexes are known, but their impact on ECG markers remains unstudied. The aim of this study was to evaluate possible differences between men and women in ECG repolarization markers for the telemonitoring of CHF patients. Method: 5 min ECG recordings were collected to assess the mean and standard deviation (SD) of the following variables: QT end (QTe), QT peak (QTp), and T peak to T end (Te) in 215 decompensated CHF (age range: from 49 to 103 years). Thirty-day mortality and high levels of NT-pro BNP (SD was shown to be the most reliable marker for CHF reacutization in both sexes. Conclusion: TeSD could be considered a risk factor for CHF worsening and complications for female and male patients, but different cut offs should be taken into account. (ClinicalTrials.gov number, NCT04127162.)
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- 2023
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4. The beneficial effects of physical exercise on visuospatial working memory in preadolescent children
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Laura Serra, Sara Raimondi, Carlotta di Domenico, Silvia Maffei, Anna Lardone, Marianna Liparoti, Pierpaolo Sorrentino, Carlo Caltagirone, Laura Petrosini, and Laura Mandolesi
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physical activity ,sport ,radial arm maze ,ecological task ,cognition ,active lifestyle ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The relationship between physical exercise and improvement in specific cognitive domains in children and adolescents who play sport has been recently reported, although the effects on visuospatial abilities have not yet been well explored. This study is aimed at evaluating in school-age children practicing artistic gymnastics the visuospatial memory by using a table version of the Radial Arm Maze (table-RAM) and comparing their performances with those ones who do not play any sport. The visuospatial performances of 14 preadolescent girls practicing artistic gymnastics aged between 7 and 10 years and those of 14 preadolescent girls not playing any sport were evaluated in the table-RAM forced-choice paradigm that allows disentangling short-term memory from working memory abilities. Data showed that the gymnasts obtained better performances than control group mainly in the parameters evaluating working memory abilities, such as within-phase errors and spatial span. Our findings emphasizing the role of physical activity on cognitive performances impel to promote physical exercise in educational and recreational contexts as well as to analyse the impact of other sports besides gymnastics on cognitive functioning.
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- 2021
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5. Gender Differences and Cardiometabolic Risk: The Importance of the Risk Factors
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Antonella Meloni, Christian Cadeddu, Lucia Cugusi, Maria Pia Donataccio, Martino Deidda, Susanna Sciomer, Sabina Gallina, Cristina Vassalle, Federica Moscucci, Giuseppe Mercuro, and Silvia Maffei
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metabolic syndrome ,gender ,cardiovascular disease ,risk factors ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Metabolic syndrome (Mets) is a clinical condition characterized by a cluster of major risk factors for cardiovascular disease (CVD) and type 2 diabetes: proatherogenic dyslipidemia, elevated blood pressure, dysglycemia, and abdominal obesity. Each risk factor has an independent effect, but, when aggregated, they become synergistic, doubling the risk of developing cardiovascular diseases and causing a 1.5-fold increase in all-cause mortality. We will highlight gender differences in the epidemiology, etiology, pathophysiology, and clinical expression of the aforementioned Mets components. Moreover, we will discuss gender differences in new biochemical markers of metabolic syndrome and cardiovascular risk.
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- 2023
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6. Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference
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John C Stevenson, Serge Rozenberg, Silvia Maffei, Christian Egarter, Petra Stute, and Thomas Römer
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menopausal hormone therapy ,progesterone ,progestogen ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Optimizing menopausal hormone therapy (MHT) requires an awareness of the benefits and risks associated with the available treatments. This narrative review, which is based on the proceedings of an Advisory Board meeting and supplemented by relevant articles identified in literature searches, examines the role of progestogens in MHT, with the aim of providing practical recommendations for prescribing physicians. Progestogens are an essential component of MHT in menopausal women with a uterus to prevent endometrial hyperplasia and reduce the risk of cancer associated with using unopposed estrogen. Progestogens include natural progesterone, dydrogesterone (a stereoisomer of progesterone), and a range of synthetic compounds. Structural differences and varying affinities for other steroid receptors (androgen, glucocorticoid, and mineralocorticoid) confer a unique biological and clinical profile to each progestogen that must be considered during treatment selection. MHT, including the progestogen component, should be tailored to each woman, starting with an estrogen and a progestogen that has the safest profile with respect to breast cancer and cardiovascular effects, while addressing patient-specific needs, risk factors, and treatment goals. Micronized progesterone and dydrogesterone appear to be the safest options, with lower associated cardiovascular, thromboembolic, and breast cancer risks compared with other progestogens, and are the first-choice options for use in ‘special situations,’ such as in women with high-density breast tissue, diabetes, obesity, smoking, and risk factors for venous thromboembolism, among others.
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- 2020
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7. Effect of Ospemifene on Densitometric and Plasma Bone Metabolism Biomarkers in Postmenopausal Women Reporting Vulvar and Vaginal Atrophy (VVA)
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Silvia Maffei and Letizia Guiducci
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bone metabolism ,postmenopausal women ,ospemifene ,Medicine - Abstract
Menopausal hormone deficiency can exert multiple effects on various organs. Vulvovaginal atrophy (VVA) is among the most widespread and disabling post-menopausal disorder. Hormonal changes can also result in a markedly increased rate of bone mineral density (BMD) loss. Ospemifene (OSP) is an SERM indicated to treat vulvar and vaginal atrophy (VVA) in postmenopausal women. This study evaluates the long-term effects of ospemifene therapy on bone metabolism and bone mineral parameters in postmenopausal women reporting VVA/GSM. Methods: Women reporting VVA symptoms were included. Bone health profile was investigated in 61 subjects treated with OSP (OSPG) (60 mg/day) and compared with a control group (CG) (n = 67) over 12 months. Results: In the CG, BMD and T-score statistically decreased at the femoral neck (FN), total femur (TF), and lumbar spine (L1–L4). In the OSPG, BMD decreased significantly at FN but tended to remain stable at TF and L1–L4. No changes were observed in bone mineral markers after one year in either group, except BAP, which decreased in OSPG. Conclusions: Long-term OSP treatment improves bone mineral markers at TF and LS and slows bone loss at FN compared to the control group. Overall, OSP exerts a protective effect on bone loss in healthy menopausal women with VVA.
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- 2022
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8. Gut Microbiota and Sex Hormones: Crosstalking Players in Cardiometabolic and Cardiovascular Disease
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Silvia Maffei, Francesca Forini, Paola Canale, Giuseppina Nicolini, and Letizia Guiducci
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gut microbiota ,diet ,sex hormone ,cardiometabolic disease ,molecular mechanisms ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The available evidence indicates a close connection between gut microbiota (GM) disturbance and increased risk of cardiometabolic (CM) disorders and cardiovascular (CV) disease. One major objective of this narrative review is to discuss the key contribution of dietary regimen in determining the GM biodiversity and the implications of GM dysbiosis for the overall health of the CV system. In particular, emerging molecular pathways are presented, linking microbiota-derived signals to the local activation of the immune system as the driver of a systemic proinflammatory state and permissive condition for the onset and progression of CM and CV disease. We further outline how the cross-talk between sex hormones and GM impacts disease susceptibility, thereby offering a mechanistic insight into sexual dimorphism observed in CVD. A better understanding of these relationships could help unravel novel disease targets and pave the way to the development of innovative, low-risk therapeutic strategies based on diet interventions, GM manipulation, and sex hormone analogues.
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- 2022
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9. Gender Differences in Knowledge and Perception of Cardiovascular Disease among Italian Thalassemia Major Patients
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Antonella Meloni, Laura Pistoia, Silvia Maffei, Paolo Marcheschi, Tommaso Casini, Anna Spasiano, Pier Paolo Bitti, Liana Cuccia, Elisabetta Corigliano, Paola Maria Grazia Sanna, Francesco Massei, Vincenzo Positano, and Filippo Cademartiri
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awareness ,knowledge ,gender differences ,cardiovascular risk ,thalassemia major ,Medicine - Abstract
We evaluated gender differences in knowledge and perception of cardiovascular disease (CVD) among Italian thalassemia major (TM) patients. An anonymous questionnaire was completed by 139 β-TM patients (87 (62.7%) females, 40.90 ± 8.03 years). Compared to females, males showed a significantly higher frequency of CVDs, and they less frequently selected tumors in general as the greatest health problem for people of the same age and gender (48.1% vs. 66.7%; p = 0.031) and as the greatest danger to their future health (26.9% vs. 43.7%; p = 0.048). CVDs were designated as the greatest danger to their future health by a significantly higher percentage of males than females (53.8% vs. 36.8%; p = 0.048). Both males and females showed a good knowledge of cardiovascular risk factors and preventive measures for CVDs. No gender differences were detected in the subjective well-being and the perceived cardiovascular risk. The perceived risk was not influenced by age, presence of cardiovascular risk factors, or disease, but no patient with a low perceived CVD risk had myocardial iron overload. Our findings highlight the need to implement future educational programs aimed at increasing the awareness of CVD as the greatest health issue, especially among the female TM population, and at informing TM patients of the different actors, besides iron, that play a role in the development of cardiovascular complications.
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- 2022
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10. Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol
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Silvia Maffei, Antonella Meloni, Martino Deidda, Susanna Sciomer, Lucia Cugusi, Christian Cadeddu, Sabina Gallina, Michela Franchini, Giovanni Scambia, Anna Vittoria Mattioli, Nicola Surico, Giuseppe Mercuro, and IGENDA Study Group
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awareness ,cardiovascular disease ,cardiovascular risk factors ,knowledge ,perception ,women ,Medicine - Abstract
A multicenter, cross-sectional observational study (Italian GENder Differences in Awareness of Cardiovascular risk, IGENDA study) was carried out to evaluate the perception and knowledge of cardiovascular risk among Italian women. An anonymous questionnaire was completed by 4454 women (44.3 ± 14.1 years). The 70% of respondents correctly identified cardiovascular disease (CVD) as the leading cause of death. More than half of respondents quoted cancer as the greatest current and future health problem of women of same age. Sixty percent of interviewed women considered CVD as an almost exclusively male condition. Although respondents showed a good knowledge of the major cardiovascular risk factors, the presence of cardiovascular risk factors was not associated with higher odds of identifying CVD as the biggest cause of death. Less than 10% of respondents perceived themselves as being at high CVD risk, and the increased CVD risk perception was associated with ageing, higher frequency of cardiovascular risk factors and disease, and a poorer self-rated health status. The findings of this study highlight the low perception of cardiovascular risk in Italian women and suggest an urgent need to enhance knowledge and perception of CVD risk in women as a real health problem and not just as a as a life-threatening threat.
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- 2022
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11. Recommendations for Physical Inactivity and Sedentary Behavior During the Coronavirus Disease (COVID-19) Pandemic
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Fabrizio Ricci, Pascal Izzicupo, Federica Moscucci, Susanna Sciomer, Silvia Maffei, Angela Di Baldassarre, Anna Vittoria Mattioli, and Sabina Gallina
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physical activity ,sedentary behavior ,cardiovascular prevention ,COVID 19 ,quarantine ,coronavirus ,Public aspects of medicine ,RA1-1270 - Published
- 2020
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12. Relationship between Bone Health Biomarkers and Cardiovascular Risk in a General Adult Population
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Cristina Vassalle, Laura Sabatino, Pietro Di Cecco, Maristella Maltinti, Rudina Ndreu, Silvia Maffei, and Alessandro Pingitore
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cardiovascular risk ,vitamin D ,bone turnover biomarkers ,FRAMINGHAM score ,PROCAM score ,Medicine - Abstract
Purpose/Introduction: Osteoporosis (OP) and cardiovascular (CV) disease emerge as closely related conditions, showing common risk factors and/or pathophysiological mechanisms. The aim of this study was to evaluate the association between bone health markers (BHM) and individual CV risk factors and overall CV risk (FRAMINGHAM-FRS, and PROCAM scores) in a general adult population. Methods: In 103 subjects (21 males; age: 56 ± 12 years), vitamin D (25(OH)D), osteocalcin (OC), bone alkaline phospatase (BALP), procollagen I aminoterminal propeptide (P1NP), CTx-telopeptide, as well clinical history and life style were evaluated. Results: Aging (p < 0.001) and glycemia (p < 0.05) emerged as independent 25(OH)D predictors. Aging (p < 0.001), male sex (p < 0.05), and obesity (p < 0.05) represented independent OC determinants. Aging (p < 0.05) was the only independent BALP determinant. After multivariate adjustment, low 25(OH)D (75th percentile-16.6 ng/mL) (6.7 (1.9–23.8) p < 0.01) were found to be significant FRS predictors, while subjects with elevated OC and/or BALP (>75th percentile-9.8 μg/L) showed a higher CV risk as estimated by PROCAM (3.6 (1.2–10.7) p < 0.05). CTx and P1NP did not significantly correlate with CV risk factors or scores. Conclusion: As we go further into bone and CV physiology, it is evident that a close relationship exists between these diseases. Further studies are needed to investigate mechanisms by which bone turnover markers are related to metabolic risk and could modulate CV risk. This knowledge may help to develop possible multiple-purpose strategies for both CV disease and OP prevention and treatment.
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- 2017
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13. Effects of ω-3 PUFAs Supplementation on Myocardial Function and Oxidative Stress Markers in Typical Rett Syndrome
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Silvia Maffei, Claudio De Felice, Pierpaolo Cannarile, Silvia Leoncini, Cinzia Signorini, Alessandra Pecorelli, Barbara Montomoli, Stefano Lunghetti, Lucia Ciccoli, Thierry Durand, Roberto Favilli, and Joussef Hayek
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Pathology ,RB1-214 - Abstract
Rett syndrome (RTT) is a devastating neurodevelopmental disorder with a 300-fold increased risk rate for sudden cardiac death. A subclinical myocardial biventricular dysfunction has been recently reported in RTT by our group and found to be associated with an enhanced oxidative stress (OS) status. Here, we tested the effects of the naturally occurring antioxidants ω-3 polyunsaturated fatty acids (ω-3 PUFAs) on echocardiographic parameters and systemic OS markers in a population of RTT patients with the typical clinical form. A total of 66 RTT girls were evaluated, half of whom being treated for 12 months with a dietary supplementation of ω-3 PUFAs at high dosage (docosahexaenoic acid ~71.9 ± 13.9 mg/kg b.w./day plus eicosapentaenoic acid ~115.5 ± 22.4 mg/kg b.w./day) versus the remaining half untreated population. Echocardiographic systolic longitudinal parameters of both ventricles, but not biventricular diastolic measures, improved following ω-3 PUFAs supplementation, with a parallel decrease in the OS markers levels. No significant changes in the examined echocardiographic parameters nor in the OS markers were detectable in the untreated RTT population. Our data indicate that ω-3 PUFAs are able to improve the biventricular myocardial systolic function in RTT and that this functional gain is partially mediated through a regulation of the redox balance.
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- 2014
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14. Erratum to 'Pro/Anti-Inflammatory Cytokine Imbalance in Postischemic Left Ventricular Remodeling'
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Anna Laura Pasqui, Michela Di Renzo, Silvia Maffei, Marcello Pastorelli, Gerarda Pompella, Alberto Auteri, and Luca Puccetti
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Pathology ,RB1-214 - Published
- 2010
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15. How to evaluate resting ECG and imaging in children practising sport: a critical review and proposal of an algorithm for ECG interpretation
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Gian Luca Ragazzoni, Luna Cavigli, Elena Cavarretta, Silvia Maffei, Giulia Elena Mandoli, Maria Concetta Pastore, Serafina Valente, Marta Focardi, Matteo Cameli, Giovanni Di Salvo, Guido Pieles, and Flavio D’Ascenzi
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Epidemiology ,Cardiology and Cardiovascular Medicine - Abstract
The athlete’s heart is a well-known phenomenon in adults practising competitive sports. Unfortunately, to date, most of the studies on training-induced cardiac remodelling have been conducted in adults and the current recommendations refer mainly to adult individuals. However, an appropriate interpretation of resting ECG and imaging in children practising sports is crucial, given the possibility of early detect life-threatening conditions and managing therapy and eligibility to sports competitions in the rapidly growing paediatric athlete population. While several articles have been published on this topic in adult athletes, a practical guide for the clinical evaluation of paediatric athletes is still missing. In this critical review, we provided a comprehensive description of the current evidence on training-induced remodelling in paediatric athletes with a practical approach for clinicians on how to interpret the resting 12-lead ECG and cardiac imaging in the paediatric athlete. Indeed, given that training may mimic potential cardiovascular disorders, clinicians evaluating children practising sports should pay attention to the risk of missing a diagnosis of a life-threatening condition. However, this risk should be balanced with the risk of overdiagnosis and unwarranted disqualification from sports practice, when interpreting an ECG as pathological while, on the contrary, it may represent a physiological expression of athlete’s heart. Accordingly, we proposed an algorithm for the evaluation of normal, borderline, and abnormal ECG findings that can be useful for the readers for their daily clinical practice.
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- 2022
16. Long-term effects of a combination of isoflavones, agnus castus and magnolia extracts on climacteric symptoms and cardiometabolic risk profile in postmenopausal women
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Silvia Maffei, Michela Franchini, Loredana Fortunato, and Letizia Guiducci
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Plant Extracts ,Endocrinology, Diabetes and Metabolism ,Cardiometabolic Risk Factors ,Obstetrics and Gynecology ,Middle Aged ,Isoflavones ,Postmenopause ,Vitex ,Treatment Outcome ,Endocrinology ,Cardiovascular Diseases ,Magnolia ,Humans ,Drug Therapy, Combination ,Female ,Prospective Studies ,Climacteric ,Phytotherapy - Abstract
To evaluate the long-term effects of a combination of isoflavones, agnus castus and magnolia extracts (combined isoflavone compound [CIC]) on climacteric symptoms and cardiometabolic risk in symptomatic postmenopausal women.This interventional, prospective study evaluated climacteric symptoms, mood and sleep disorders using the 21-item Greene Climacteric Scale (GCS) and 7-item Insomnia Severity Index (ISI) questionnaires; and cardiovascular, metabolic and thrombotic risk markers at baseline (T0) and after 12 months of CIC treatment (T1).In healthy postmenopausal women (Long-term CIC therapy improved vasomotor symptoms, mood disorders, sleep disorders, hemodynamic measurements and cardiometabolic risk markers in healthy postmenopausal women.NCT03699150.
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- 2022
17. Effect of Ospemifene on Cardiometabolic Risk in Postmenopausal Women Reporting Vulvo and Vaginal Atrophy (VVA): Results of a 12-Month Prospective Study
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Silvia Maffei
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- 2021
18. Bone status and HCV infection in thalassemia major patients
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Antonella Meloni, Laura Pistoia, Silvia Maffei, Paolo Ricchi, Tommaso Casini, Elisabetta Corigliano, Maria Caterina Putti, Liana Cuccia, Crocetta Argento, Vincenzo Positano, Alessia Pepe, Filippo Cademartiri, and Cristina Vassalle
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Bone health ,Histology ,BMD ,Physiology ,Endocrinology, Diabetes and Metabolism ,HCV ,β-Thalassemia major ,Bone turnover biomarkers ,Vitamin D - Published
- 2023
19. Impact of COVID-19 on the cardiovascular health of women: a review by the Italian Society of Cardiology Working Group on 'gender cardiovascular diseases'
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Federica Moscucci, Sabina Gallina, Valentina Bucciarelli, Alberto Aimo, Giovanna Pelà, Christian Cadeddu-Dessalvi, Savina Nodari, Silvia Maffei, Antonella Meloni, Martino Deidda, Giuseppe Mercuro, Roberto Pedrinelli, Maria Penco, Susanna Sciomer, and Anna Vittoria Mattioli
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
20. IGENDA protocol
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Antonella Meloni, Emanuela Colasante, Silvia Maffei, Martino Deidda, Lucia Cugusi, Nicola Surico, Roberto Marchioli, and Giuseppe Mercuro
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Protocol (science) ,Gerontology ,Research design ,business.industry ,Cross-sectional study ,media_common.quotation_subject ,MEDLINE ,General Medicine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Perception ,Medicine ,Observational study ,030212 general & internal medicine ,Young adult ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,media_common - Abstract
Aims Recent reports evidenced gender differences in the knowledge, perception and awareness of cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs). Despite the number of high-quality trials that attempted to establish the efficacy of different preventive interventions on CVDs, in the Italian scenario the differences by gender in awareness, knowledge and perception of CVD have not been addressed yet. So, the aims of this cross-sectional, observational and multicenter study will be to evaluate the gender differences in the awareness and perception of CVD risk, to assess the knowledge of CVD symptoms and preventive behaviors/barriers in men and women participating in this study, and to provide a national primary care approach for gender-oriented cardiovascular prevention strategies and therapy. Methods A self-administered questionnaire will be completed by 5000 consecutive Italian women and men aged 18-70 years. Moreover, a health questionnaire will be completed by the physicians. Results The present study will be the largest to be conducted in Italy, and probably in the European countries, to comprehensively demonstrate the current level of the knowledge, awareness and perception of CVRFs and CVD in both men and women. Conclusion The present project could shed new light on the knowledge, awareness and perception of CVRFs and CVDs. If substantial differences will be detected by gender, the findings of this study may contribute to ultimately provide a new gender-oriented primary care approach inside the Italian healthcare system related to cardiovascular prevention and therapy strategies.
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- 2019
21. The beneficial effects of physical exercise on visuospatial working memory in preadolescent children
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Anna Lardone, Carlo Caltagirone, Marianna Liparoti, Laura Serra, Laura Petrosini, Carlotta Di Domenico, Silvia Maffei, Laura Mandolesi, Sara Raimondi, Pierpaolo Sorrentino, Serra, Laura, Raimondi, Sara, di Domenico, Carlotta, Maffei, Silvia, Lardone, Anna, Liparoti, Marianna, Sorrentino, Pierpaolo, Caltagirone, Carlo, Petrosini, Laura, Mandolesi, Laura, Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)
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ecological task ,cognition ,radial arm maze ,medicine.medical_specialty ,Working memory ,[SCCO.NEUR]Cognitive science/Neuroscience ,General Neuroscience ,physical activity ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Physical exercise ,Physical medicine and rehabilitation ,active lifestyle ,medicine ,sport ,Psychology ,Beneficial effects ,Research Article ,RC321-571 - Abstract
The relationship between physical exercise and improvement in specific cognitive domains in children and adolescents who play sport has been recently reported, although the effects on visuospatial abilities have not yet been well explored. This study is aimed at evaluating in school-age children practicing artistic gymnastics the visuospatial memory by using a table version of the Radial Arm Maze (table-RAM) and comparing their performances with those ones who do not play any sport. The visuospatial performances of 14 preadolescent girls practicing artistic gymnastics aged between 7 and 10 years and those of 14 preadolescent girls not playing any sport were evaluated in the table-RAM forced-choice paradigm that allows disentangling short-term memory from working memory abilities. Data showed that the gymnasts obtained better performances than control group mainly in the parameters evaluating working memory abilities, such as within-phase errors and spatial span. Our findings emphasizing the role of physical activity on cognitive performances impel to promote physical exercise in educational and recreational contexts as well as to analyse the impact of other sports besides gymnastics on cognitive functioning.
- Published
- 2021
22. Sex-related differences in ventricular remodeling after myocardial infarction
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Alberto Aimo, Riccardo Liga, Andrea Barison, Silvia Maffei, Michele Emdin, Doralisa Morrone, Flavio D'Ascenzi, Matteo Cameli, Iacopo Olivotto, Rossella Marcucci, Stefano Coiro, Carlo Di Mario, Giorgia Panichella, and Isabella Tritto
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Male ,medicine.medical_specialty ,Left ,Myocardial Infarction ,Heart failure ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,Internal medicine ,Epidemiology ,Sex differences ,medicine ,Ventricular Dysfunction ,Humans ,Ventricular Function ,Women ,Myocardial infarction ,Ventricular remodeling ,Sex Characteristics ,Ventricular Remodeling ,business.industry ,Sex related ,medicine.disease ,Remodeling ,Menopause ,Increased risk ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Sex characteristics - Abstract
The epidemiology, clinical features and outcome of myocardial infarction (MI) display significant differences between men and women. Prominent sex differences have also been suggested in left ventricular (LV) remodeling after MI. Ventricular remodeling refers to a deterioration of LV geometry and function often leading to heart failure (HF) development and an increased risk of adverse cardiovascular events. Women have a lower propensity to the acquisition of a spherical geometry and LV dysfunction. These differences can be attributed at least partially to a lower frequency of transmural infarction and smaller areas of microvascular obstruction in women, as well as to a less prominent activation of neuroendocrine systems and apoptotic, inflammatory and profibrotic pathways in women. Estrogens might play a role in this difference, which could partially persist even after the menopause because of a persisting intramyocardial synthesis of estrogens in women. Conversely, androgens may exert a detrimental influence. Future studies should better clarify sex differences in the predictors, clinical correlates, prognostic impact and disease mechanisms of remodeling, as well as the existence of sex-specific therapeutic targets. This research effort should hopefully allow to optimize the treatment of MI during the acute and post-acute phase, possibly through different therapeutic strategies in men and women, with the goal of reducing the risk of HF development and improving patient outcome.
- Published
- 2021
23. Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease
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Camilla Cocchi, Sabina Gallina, Susanna Sciomer, Anna Vittoria Mattioli, and Silvia Maffei
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obesity ,Endocrinology, Diabetes and Metabolism ,physical activity ,Medicine (miscellaneous) ,Disease ,030204 cardiovascular system & hematology ,law.invention ,stress ,0302 clinical medicine ,law ,Pandemic ,gender ,Medicine ,humans ,Depression (differential diagnoses) ,education.field_of_study ,Nutrition and Dietetics ,exercise ,quarantine ,vitamin d ,anxiety ,female ,covid-19 ,Anxiety ,medicine.symptom ,Diet, Healthy ,sex characteristics ,Cardiology and Cardiovascular Medicine ,viral ,lifestyle ,vit D ,Isolation (health care) ,Population ,Pneumonia, Viral ,cardiovascular diseases ,coronavirus infections ,disease outbreaks ,life style ,male ,pandemics ,pneumonia, viral ,stress, psychological ,betacoronavirus ,diet, healthy ,030209 endocrinology & metabolism ,healthy ,Article ,03 medical and health sciences ,gender, physical activity, vit D ,Environmental health ,Quarantine ,pneumonia ,education ,business.industry ,SARS-CoV-2 ,Outbreak ,psychological ,business ,diet ,Stress, Psychological - Abstract
Aims CoV-19/SARS-CoV-2 is a highly pathogenic virus that is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of infection, several governments have enforced restrictions on outdoor activities or even collective quarantine on the population. The present commentary briefly analyzes the effects of quarantine on lifestyle, including nutrition and physical activity and the impact of new technologies in dealing with this situation. Data synthesis Quarantine is associated with stress and depression leading to unhealthy diet and reduced physical activity. A diet poor in fruit and vegetables is frequent during isolation, with a consequent low intake of antioxidants and vitamins. However, vitamins have recently been identified as a principal weapon in the fight against the Cov-19 virus. Some reports suggest that Vitamin D could exert a protective effect on such infection. During quarantine, strategies to further increase home-based physical activity and to encourage adherence to a healthy diet should be implemented. The WHO has just released guidance for people in self-quarantine, those without any symptoms or diagnosis of acute respiratory illness, which provides practical advice on how to stay active and reduce sedentary behavior while at home. Conclusion Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine, a global action supporting healthy diet and physical activity is mandatory to encourage people to return to a good lifestyle routine.
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- 2020
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24. 1634 3D transoesofageal echocardiography in detection of anterior leaflet laceration during mitraclip implantation
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G Benedetti, Massimiliano Mariani, Silvia Maffei, Giuseppe Trianni, F Pizzino, A. J. Al Jabri, Sergio Berti, A G Cerillo, S Sorbo, S Chiappino, Marcello Ravani, Federica Marchi, Luigi Zezza, Umberto Paradossi, and E Cerone
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medicine.medical_specialty ,Anterior leaflet ,business.industry ,MitraClip ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,business ,Surgery - Abstract
Background MitraClip is a percutaneous way of treatment of mitral regurgitation. Recent trials demonstrate its value in modifying prognosis of patients with functional mitral regurgitation. During MitraClip implant imaging with 3D TEE is mandatory to guide the procedure and monitoring the results. Unfortunately, laceration of mitral leaflets is a well-described complication of Percutaneous Mitral valve repair by implantation of MitraClip. 3D TEE can be useful even to detect complication of the procedure and in particular leaflets lacerations. Here we describe a case where 3D TEE was capable to recognize and visualize a laceration in the anterior leaflet (AL) and we assume some mechanisms leading to this complication. Methods An 83 years old man with post-ischemic severe functional mitral regurgitation underwent to MitraClip implantation. The mitral valve shows a severe tenting and annulus was deformed and dilated. The procedure was performed under fluoroscopic and 3D TEE guidance (Philips iE33). Due to the large central regurgitation and large coaptation gap, we decide to implant MitraClip XTR, this is the larger device 5 mm longer. Results A single MitraClip XTR was implanted in the central scallop (A2-P2) in the region of the larger jet, after device positioning a further jet was detected in the region of implant and the original jet was unchanged. Using 3D color complete volume and X-plane reconstructions we recognize that the jet originates between the clip and the basal aspects of AL. Without color Doppler in 3D zoom and X plane reconstruction, a continuum solution was suspected in the body of AL but the shadow of the delivery system partially masked the region. After removal of the device, perforation of AL was clearly depicted also with 3D zoom without color Doppler. The patient was surgically treated and inspection confirmed the laceration and shows a worn thin AL. The laceration of AL can be caused by the tension on a thinned tissue carried out by the large device. The severe tethering and annular dilatation with a marked distance between anterior and posterior leaflet at the tip of the device may have been a determinant factor in the tear occurrence. Conclusion 3D TEE can clearly depict lacerations of leaflets during MitraClip implantation. Preoperative extensive analysis of valve geometry and inspection of leaflets searching for a thinned region can avoid intraoperative complications. The distance between leaflets at the expected tips of the MitraClip can be a predictive parameter of tension applied on the leaflets and of the risk of tearing. Abstract 1634 Figure. Image 1
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- 2020
25. Lifestyle and Stress Management in Women During COVID-19 Pandemic: Impact on Cardiovascular Risk Burden
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Anna Vittoria Mattioli, Sabina Gallina, Silvia Maffei, and Susanna Sciomer
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Stress management ,lifestyle ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Population ,Medicine (miscellaneous) ,medicine.disease_cause ,law.invention ,stress ,law ,Environmental health ,Pandemic ,Quarantine ,Medicine ,education ,women, lifestyle, stress, quarantine ,Depression (differential diagnoses) ,Coronavirus ,education.field_of_study ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,quarantine ,Commentary ,women ,business - Abstract
CoV-19/SARS-CoV-2 (coronavirus 2019/severe acute respiratory syndrome coronavirus 2) is a virus that has caused a pandemic with high numbers of deaths worldwide. To contain the diffusion of infection, several governments have enforced restrictions on outdoor activities on the population. Today, we are witnessing the so-called “second wave” COVID-19 (coronavirus disease 2019) with an increasing number of cases similar to the one reported at the beginning of the current year. It is plausible that further restrictions will be applied to contain the “second wave” of infections. The present commentary evaluated the effects of stress on lifestyle during the COVID-19 pandemic in women. We briefly suggest practical recommendations for women to reduce stress and recovery for a healthy lifestyle after quarantine. Quarantine is associated with stress and depression, which lead to unhealthy lifestyle, including unhealthy diet, smoking, alcohol, and reduced physical activity. Women are more likely to suffer from depression and stress and quarantine has acted as a trigger. The prolongation of the COVID-19 pandemic around the world requires decisive action to correct the unhealthy lifestyle that has developed in recent months.
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- 2020
26. Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference
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Silvia Maffei, Christian Egarter, John C. Stevenson, Thomas Römer, Serge Rozenberg, and Petra Stute
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medicine.drug_class ,medicine.medical_treatment ,menopausal hormone therapy ,030209 endocrinology & metabolism ,610 Medicine & health ,Review ,Dydrogesterone ,Pharmacologie ,progesterone ,Bioinformatics ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Diabetes mellitus ,medicine ,Progesterone ,Pharmacology ,030219 obstetrics & reproductive medicine ,Progestogen ,progestogen ,business.industry ,lcsh:RM1-950 ,Cancer ,Biologie moléculaire ,General Medicine ,medicine.disease ,Androgen ,Endometrial hyperplasia ,lcsh:Therapeutics. Pharmacology ,Estrogen ,Molecular Medicine ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Menopausal hormone therapy - Abstract
Optimizing menopausal hormone therapy (MHT) requires an awareness of the benefits and risks associated with the available treatments. This narrative review, which is based on the proceedings of an Advisory Board meeting and supplemented by relevant articles identified in literature searches, examines the role of progestogens in MHT, with the aim of providing practical recommendations for prescribing physicians. Progestogens are an essential component of MHT in menopausal women with a uterus to prevent endometrial hyperplasia and reduce the risk of cancer associated with using unopposed estrogen. Progestogens include natural progesterone, dydrogesterone (a stereoisomer of progesterone), and a range of synthetic compounds. Structural differences and varying affinities for other steroid receptors (androgen, glucocorticoid, and mineralocorticoid) confer a unique biological and clinical profile to each progestogen that must be considered during treatment selection. MHT, including the progestogen component, should be tailored to each woman, starting with an estrogen and a progestogen that has the safest profile with respect to breast cancer and cardiovascular effects, while addressing patient-specific needs, risk factors, and treatment goals. Micronized progesterone and dydrogesterone appear to be the safest options, with lower associated cardiovascular, thromboembolic, and breast cancer risks compared with other progestogens, and are the first-choice options for use in 'special situations,' such as in women with high-density breast tissue, diabetes, obesity, smoking, and risk factors for venous thromboembolism, among others., SCOPUS: re.j, info:eu-repo/semantics/published
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- 2020
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27. P4571PFA-100, a test of platelet adhesion/aggregation, predicts cardiovascular events after an acute coronary syndrome and can help in the decision-making for dual antiplatelet extension
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A. R. De Caterina, Jacopo Gianetti, Maria Serena Parri, R Scattina, Michele Emdin, Sergio Berti, Umberto Paradossi, F Pizzino, G Benedetti, F. Della Pina, Silvia Maffei, and S Chiappino
- Subjects
Acute coronary syndrome ,medicine.medical_specialty ,business.industry ,Internal medicine ,Platelet adhesion ,medicine ,Cardiology ,DUAL (cognitive architecture) ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Abstract
Background The dual antiplatelet therapy (DAPT) duration is a matter of great interest among cardiologists. Because of the conflicting evidences and the necessity to balance the reduction in major cardiac events (MACE) occurrence and the risk of major bleedings after an acute coronary syndrome (ACS), there is a general consensus on prolonging DAPT on an individual basis. There is less consensus on which parameters are to be evaluated. Nowadays tests of platelet reactivity are not included in the decision-making. Few data are available on the prognostic value of aspirin response tests that are sensitive to other mediators of platelet adhesion and aggregation in vivo under flow conditions. Purpose To demonstrate the role of the Platelet Function Analyzer (PFA-100) Collagen/Epinephrine (CEPI) cartridge, which is very sensitive to von Willebrand factor (VWF) levels, an emerging vascular risk factor, in risk stratification in ACS patients undergoing percutaneous coronary intervention (PCI). Methods We measured platelet reactivity by PFA-100 CEPI cartridges in a prospective cohort of 928 patients admitted for ACS between January 2006 to December 2009 and urgently treated by PCI at day 6±1 after admission. All the patients were treated with aspirin and clopidogrel according to current standard of that time. Results High platelet reactivity (HPR) defined as PFA-100 values 190”). At a mean follow up of 5±1 years patients with HPR had a significant increase in cardiac death: 12.3% vs 2.6% (hazard ratio 6.05; 95% confidence interval: 3.34–10.95; p Conclusions Using a multivariable Cox-proportional hazard model, HPR was found to be an independent predictor of MACE. These results indicate that PFA-100 CEPI cartridge, which correlates well with VWF levels, may be a useful point-of-care test to stratify the cardiovascular risk after an ACS. This also underlines the additional value of this test in the decision-making about the correct extension of DAPT.
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- 2019
28. Significance of the ionized calcium measurement to assess calcium status in osteopenic/osteoporosis postmenopausal outpatients
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Pietro Di Cecco, Silvia Maffei, Letizia Guiducci, Alessandro Vannucci, Laura Sabatino, Debora Battaglia, Luc Zyw, and Cristina Vassalle
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medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Nutritional Status ,chemistry.chemical_element ,Parathyroid hormone ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Calcium ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Outpatients ,medicine ,Vitamin D and neurology ,Humans ,Osteoporosis, Postmenopausal ,Aged ,Ions ,Calcium metabolism ,biology ,business.industry ,Albumin ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Postmenopause ,Bone Diseases, Metabolic ,Italy ,chemistry ,cardiovascular system ,Osteocalcin ,biology.protein ,Female ,Total calcium ,business - Abstract
Evaluation of calcium status is important in the osteoporotic risk assessment. Although guidelines indicate total calcium (tCa) as first-line measurement, directly measured ionized calcium (m-iCa), considered as the gold standard, is more and more often required. Aim of this study is to evaluate the agreement between m-iCa, tCa and iCa calculated from a formula based on total calcium and albumin (c-iCa) in osteopenic/osteoporotic postmenopausal outpatients.A total of 140 postmenopausal outpatients, 41 osteopenic (OPN) and 99 osteoporotic (OP) were enrolled. Levels of tCa, m-iCa, c-iCa, total protein and albumin, vitamin D (25-OHD), parathyroid hormone 1-84 (PTH), bone alkaline phosphatase, osteocalcin and serum collagen type 1 cross-linked C-telopeptide (CTX) were also measured.There were no statistically significant differences between OPN and OP groups regarding values of tCa, m-iCa, and c-iCa, 25-OHD and PTH. However, OP women had lower levels of CTX (p 0.05). A significant direct correlation between m-iCa and tCa (r = 0.60, p 0.001) and c-iCa (r = 0.61, p 0.001) was found. Women with isolated hyper-m-iCa had similar DEXA parameter levels respect to the other patients. However, one patient with confirmed primary hyperparathyroidism presented hyper-m-iCa versus normal tCa and c-iCa values.The use of tCa could be sufficient to characterize the calcium status in postmenopausal outpatients, but reflexive calcium testing strategy for m-iCa test is necessary to women presenting the low or high extremes of tCa levels, or in women with suspected PHPT.
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- 2017
29. IGENDA protocol: gender differences in awareness, knowledge and perception of cardiovascular risk: an Italian multicenter study
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Silvia, Maffei, Lucia, Cugusi, Antonella, Meloni, Martino, Deidda, Emanuela, Colasante, Roberto, Marchioli, Nicola, Surico, and Giuseppe, Mercuro
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,Adolescent ,Awareness ,Middle Aged ,Risk Assessment ,Young Adult ,Cross-Sectional Studies ,Sex Factors ,Italy ,Cardiovascular Diseases ,Research Design ,Risk Factors ,Surveys and Questionnaires ,Humans ,Female ,Perception ,Aged - Abstract
Recent reports evidenced gender differences in the knowledge, perception and awareness of cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs). Despite the number of high-quality trials that attempted to establish the efficacy of different preventive interventions on CVDs, in the Italian scenario the differences by gender in awareness, knowledge and perception of CVD have not been addressed yet. So, the aims of this cross-sectional, observational and multicenter study will be to evaluate the gender differences in the awareness and perception of CVD risk, to assess the knowledge of CVD symptoms and preventive behaviors/barriers in men and women participating in this study, and to provide a national primary care approach for gender-oriented cardiovascular prevention strategies and therapy.A self-administered questionnaire will be completed by 5000 consecutive Italian women and men aged 18-70 years. Moreover, a health questionnaire will be completed by the physicians.The present study will be the largest to be conducted in Italy, and probably in the European countries, to comprehensively demonstrate the current level of the knowledge, awareness and perception of CVRFs and CVD in both men and women.The present project could shed new light on the knowledge, awareness and perception of CVRFs and CVDs. If substantial differences will be detected by gender, the findings of this study may contribute to ultimately provide a new gender-oriented primary care approach inside the Italian healthcare system related to cardiovascular prevention and therapy strategies.
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- 2019
30. Cardiovascular prevention in women. a narrative review from the italian society of cardiology working groups on 'cardiovascular prevention, hypertension and peripheral circulation' and on 'women disease'
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Anna Vittoria Mattioli, Federica Moscucci, Lucia Cugusi, Carolina Lombardi, Sabina Gallina, Pasquale Palmiero, Susanna Sciomer, Giuseppe Mercuro, Gianfranco Parati, Marco Matteo Ciccone, Alessandra Dei Cas, Maria Maiello, Francesco Barillà, Martino F. Pengo, Silvia Maffei, Mattioli, A, Sciomer, S, Moscucci, F, Maiello, M, Cugusi, L, Gallina, S, Dei Cas, A, Lombardi, C, Pengo, M, Parati, G, Barilla, F, Ciccone, M, Palmiero, P, Mercuro, G, and Maffei, S
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Male ,cardiovascular risk factors ,physical activity ,Sex Factor ,Type 2 diabetes ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular System ,diabetes ,obstructive sleep apnea ,women ,Coronary artery disease ,Settore MED/11 ,0302 clinical medicine ,prevention ,Pregnancy ,Risk Factors ,Cardiovascular Disease ,Prevalence ,cardiovascular risk factor ,Age Factor ,030212 general & internal medicine ,Health Status Disparitie ,Age Factors ,General Medicine ,Middle Aged ,Prognosis ,Gestational diabetes ,Cardiovascular Diseases ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,women, prevention, physical activity ,Human ,Adult ,medicine.medical_specialty ,Prognosi ,Risk Assessment ,03 medical and health sciences ,Sex Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Healthy Lifestyle ,Risk factor ,Exercise ,Protective Factor ,Aged ,business.industry ,Risk Factor ,Health Status Disparities ,Protective Factors ,medicine.disease ,Diabetes, Gestational ,Blood pressure ,Years of potential life lost ,Diabetes Mellitus, Type 2 ,diabete ,Women's Health ,business ,Risk Reduction Behavior - Abstract
Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in women.Some authors highlighted that the female risk profile consists of traditional and emerging risk factors. Despite the lower prevalence of type 2 diabetes, years of life lost owing to the disease for women are substantially higher compared with men. In addition, pregnancy complicated by gestational diabetes represents a risk factor for CVD. Women with gestational diabetes have a higher prevalence of coronary artery disease that occur at a younger age and are independent of T2DM.Hypertension is an important cardiovascular risk factor in women. Estrogens and progesterone, known to have an impact on blood pressure levels, have also been proposed to be protective against sleep-disordered breathing. It is very difficult to understand whereas obstructive sleep apnea in women is independently associated with hypertension or if many confounders acting at different stages of the woman lifespan mediate this relation.The cardioprotective effect of physical activity in women of all ages is well known. Women are generally more physically inactive than men. During and after menopause, most women tend to reduce their physical activity levels and together with the reduction in basal metabolic rate, women experience loss of skeletal muscle mass with a negative change in the ratio of fat-to-lean mass.In conclusion, sex differences in the cardiovascular system are because of dissimilarities in gene expression and sex hormones; these result in variations in prevalence and presentation of CVD and associated conditions, such as diabetes, hypertension and vascular and cardiac remodeling.Changes in lifestyle and increase in physical activity could help in prevention of cardiovascular disease in women.
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- 2019
31. Gender differences for uric acid as predictor of hard events in patients referred for coronary angiography
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Kyriazoula Chatzianagnostou, Debora Battaglia, Alessandro Vannucci, Clara Carpeggiani, Letizia Guiducci, Caterina Arvia, Cristina Vassalle, Patrizia Landi, and Silvia Maffei
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Male ,Coronary angiography ,medicine.medical_specialty ,Clinical Biochemistry ,Myocardial Infarction ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Coronary Angiography ,03 medical and health sciences ,chemistry.chemical_compound ,Sex Factors ,0302 clinical medicine ,Internal medicine ,Drug Discovery ,Female patient ,medicine ,Humans ,In patient ,Obesity ,030212 general & internal medicine ,Hyperuricemia ,Myocardial infarction ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Biochemistry (medical) ,Age Factors ,Middle Aged ,medicine.disease ,Uric Acid ,Large cohort ,Surgery ,Antioxidant capacity ,chemistry ,Multivariate Analysis ,Uric acid ,Female ,business ,Glomerular Filtration Rate - Abstract
Aim: To assess gender differences in uric acid (UA) as predictor for hard events (HE, mortality and nonfatal myocardial infarction) in a large cohort of patients referred for coronary angiography. Design & patients: 3020 inpatients (2177 males, age: 68 ± 9 years, mean ± SD) were retrospectively studied, collecting data from the Institute electronic databank which included demographic, clinical, instrumental and follow-up data. Results: Although the Kaplan–Meier survival estimates showed a significantly worst outcome in female patients, high UA did not remained a significant predictor for HE after adjustment. Moreover, UA correlated with antioxidant capacity in both sexes. Conclusion: Hyperuricemia was not an independent risk for HE, and being correlated with antioxidant capacity, its elevation appears more likely compensatory than causative for HE.
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- 2016
32. Sex-related differences in chronic heart failure
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Silvia Maffei, Ketty Savino, Elisabetta Cerbai, Giuseppe Vergaro, Giuseppe Ambrosio, Alberto Aimo, Rossella Marcucci, Matteo Cameli, Andrea Barison, Chiara Borrelli, Roberto Pedrinelli, Stefano Coiro, Alberto Palazzuoli, Michele Emdin, Luigi Padeletti, Claudio Passino, and Doralisa Morrone
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Differences ,Heart failure ,Sex ,Cardiac Resynchronization Therapy ,Cardiovascular Agents ,Chronic Disease ,Female ,Heart Failure ,Humans ,Randomized Controlled Trials as Topic ,Sex Characteristics ,Cardiology and Cardiovascular Medicine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Epidemiology ,medicine ,030212 general & internal medicine ,Heart transplantation ,Ejection fraction ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Etiology ,Cardiology ,business - Abstract
The prevalence of chronic heart failure (CHF) is steadily increasing. Both sexes are affected, with significant differences in etiology, epidemiology and clinical presentation, prognosis, comorbidities, and response to treatment. Women tend to develop CHF at a more advanced age, present more often with HF with preserved ejection fraction, are more symptomatic, and have a worse quality of life than men, but also a better prognosis. In women, CHF has more frequently a non-ischemic etiology, and arterial hypertension and diabetes mellitus are leading comorbidities. Furthermore, many sex-related differences have been detected in the response to treatment, for example a greater prognostic benefit from angiotensin-receptor blockers in women, a higher incidence of complications after defibrillator implantation, and a greater response to cardiac resynchronization therapy. Furthermore, women are less likely to receive defibrillator therapy or heart transplantation. The significant underrepresentation of women in clinical trials limits our capacity to evaluate the extent of sex-related differences in CHF, although their characterization seems crucial in order to achieve the ultimate goal of a tailored therapy for this condition.
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- 2018
33. Gender differences in the development of cardiac complications: a multicentre study in a large cohort of thalassaemia major patients to optimize the timing of cardiac follow-up
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Silvia Maffei, Massimiliano Missere, Liana Cuccia, Massimo Midiri, Anna Spasiano, Caterina Borgna, Christian Cadeddu, Maria Rita Gamberini, Antonella Meloni, Maurizio Mangione, Alessia Pepe, and Laura Pistoia
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Adult ,Male ,medicine.medical_specialty ,Iron ,Myocardial iron ,030204 cardiovascular system & hematology ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,Ventricular Dysfunction ,medicine ,Humans ,In patient ,Heart Failure ,Sex Characteristics ,Hematology ,Thalassaemia major ,business.industry ,beta-Thalassemia ,Arrhythmias, Cardiac ,medicine.disease ,Magnetic Resonance Imaging ,Large cohort ,Survival Rate ,Heart failure ,Cohort ,Cardiology ,Female ,business ,Follow-Up Studies - Abstract
We assessed whether male gender was associated with a higher risk of cardiac iron accumulation and fibrosis, heart dysfunction and complications in a large, multicentre cohort of thalassaemia major (TM) patients, in order to optimize the timing in cardiac follow-up. We considered 1711 TM patients (899 females, 31·09 ± 9·08 years), enrolled in the Myocardial Iron Overload in Thalassaemia Network. Clinical/instrumental data are recorded from birth to the first Cardiovascular Magnetic Resonance Imaging scan. Although having a similar risk of accumulating iron, males showed a significantly higher risk of developing cardiac dysfunction, heart failure, arrhythmias and cardiac complications overall, when compared to females (P < 0·0001). Up to 20-30 years of follow-up, the Kaplan-Meier curves for the outcomes for which the male sex was a significant prognosticator almost overlapped, whereas they clearly diverged after this period. In patients with follow-up longer than 20 years, males exhibited a significantly higher risk of ventricular dysfunction, heart failure, arrhythmias, and cardiac complications. Female patients may have an intrinsically better tolerance for iron toxicity. International guidelines suggest annual cardiac evaluation for thalassaemia patients. It is possible that female patients can be evaluated at longer intervals, thus reducing health costs.
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- 2018
34. Prevention of cardiovascular risk factors in women. the lifestyle paradox and stereotypes we need to defeat
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Anna Vittoria Mattioli, Susanna Sciomer, Silvia Maffei, Sabina Gallina, and Federica Moscucci
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Gerontology ,medicine.medical_treatment ,Cardiovascular risk factors ,MEDLINE ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Sex factors ,Preventive Health Services ,medicine ,Humans ,Healthy Lifestyle ,030212 general & internal medicine ,Exercise ,Stereotyping ,Gender identity ,Life style ,business.industry ,cardiovascular prevention ,Gender Identity ,Protective Factors ,epidemiology ,cardiology and cardiovascular medicine ,Cardiovascular Diseases ,Women's Health ,Smoking cessation ,Female ,Smoking Cessation ,Diet, Healthy ,business ,Risk assessment ,Risk Reduction Behavior - Published
- 2018
35. Sex-specific echocardiographic reference values: the women's point of view
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Regina Sorrentino, Roberta Esposito, Lucia La Mura, Patrizio Lancellotti, F Luciano, Anna Maria De Roberto, Maurizio Galderisi, Silvia Maffei, Maria Lembo, Marta Petitto, Enrica Pezzullo, Petitto, Marta, Esposito, Roberta, Sorrentino, Regina, Lembo, Maria, Luciano, Federica, De Roberto, Anna Maria, LA MURA, Lucia, Pezzullo, Enrica, Maffei, Silvia, Galderisi, Maurizio, and Lancellotti, Patrizio
- Subjects
Adult ,Male ,medicine.medical_specialty ,Heart Ventricles ,Diastole ,Echocardiography, Three-Dimensional ,Predictive Value of Test ,Disease ,Sex Factor ,030204 cardiovascular system & hematology ,Affect (psychology) ,Ventricular Function, Left ,Heart Ventricle ,03 medical and health sciences ,Young Adult ,Sex Factors ,0302 clinical medicine ,Predictive Value of Tests ,Reference Values ,Internal medicine ,Cardiovascular Disease ,medicine ,Humans ,Age Factor ,Reference Value ,030212 general & internal medicine ,Ejection fraction ,business.industry ,Age Factors ,Stroke Volume ,General Medicine ,Stroke volume ,Middle Aged ,medicine.disease ,Sex specific ,Myocardial Contraction ,Echocardiography, Doppler ,Cardiovascular Diseases ,Reference values ,Heart failure ,Cardiology ,Women's Health ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Clinical presentation, diagnosis and outcomes of cardiac diseases are influenced by the activity of sex steroid hormones. These hormonal differences explain the later development of heart diseases in women in comparison with men and the different clinical picture, management and prognosis. Echocardiography is a noninvasive and easily available technique for the analysis of cardiac structure and function. The aim of the present review is to underline the most important echocardiographic differences between sexes. Several echocardiographic studies have found differences in healthy populations between women and men. Sex-specific difference of some of these parameters, such as left ventricular (LV) linear dimensions and left atrial volume, can be explained on the grounds of smaller body size of women, but other parameters (LV volumes, stroke volume and ejection fraction, right ventricular size and systolic function) are specifically lower in women, even after adjusting for body size and age. Sex-specific differences of standard Doppler and Tissue Doppler diastolic indices remain controversial, but it is likely for aging to affect LV diastolic function more in women than in men. Global longitudinal strain appears to be higher in women during the childbearing age - a finding that also highlights a possible hormonal influence in women. All these findings have practical implications, and sex-specific reference values are necessary for the majority of echocardiographic parameters in order to distinguish normalcy from disease. Careful attention on specific cut-off points in women could avoid misinterpretation, inappropriate management and delayed treatment of cardiac diseases such as valvular disease and heart failure.
- Published
- 2018
36. The different role of sex hormones on female cardiovascular physiology and function: not only oestrogens
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Silvia Maffei, Flavio Acquistapace, Sabina Gallina, Samanta Di Francescomarino, Christian Cadeddu, and Sara Salerni
- Subjects
medicine.medical_specialty ,medicine.drug_class ,Clinical Biochemistry ,Biology ,Autonomic Nervous System ,Bioinformatics ,Biochemistry ,Cardiovascular Physiological Phenomena ,Internal medicine ,medicine ,Animals ,Humans ,Gonadal Steroid Hormones ,Excitation Contraction Coupling ,Progesterone ,Estrogens ,Heart ,General Medicine ,Androgen ,Cardiovascular physiology ,Autonomic nervous system ,Endocrinology ,Androgens ,Female ,Calcium Channels ,Menopause ,Function (biology) ,Forecasting ,Signal Transduction ,Hormone - Abstract
Human response to different physiologic stimuli and cardiovascular (CV) adaptation to various pathologies seem to be gender specific. Sex-steroid hormones have been postulated as the major contributors towards these sex-related differences. This review will discuss current evidence on gender differences in CV function and remodelling, and will present the different role of the principal sex-steroid hormones on female heart. Starting from a review of sex hormones synthesis, receptors and CV signalling, we will summarize the current knowledge concerning the role of sex hormones on the regulation of our daily activities throughout the life, via the modulation of autonomic nervous system, excitation-contraction coupling pathway and ion channels activity. Many unresolved questions remain even if oestrogen effects on myocardial remodelling and function have been extensively studied. So this work will focus attention also on the controversial and complex relationship existing between androgens, progesterone and female heart.
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- 2015
37. Relationship between Bone Health Biomarkers and Cardiovascular Risk in a General Adult Population
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Silvia Maffei, Maristella Maltinti, Alessandro Pingitore, Pietro Di Cecco, Cristina Vassalle, Rudina Ndreu, and Laura Sabatino
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cardiovascular risk ,medicine.medical_specialty ,Osteoporosis ,Adult population ,lcsh:Medicine ,Physiology ,030209 endocrinology & metabolism ,vitamin D ,PROCAM score ,Disease ,030204 cardiovascular system & hematology ,Article ,Bone remodeling ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Vitamin D and neurology ,FRAMINGHAM score ,Framingham Risk Score ,biology ,business.industry ,lcsh:R ,medicine.disease ,Pathophysiology ,Endocrinology ,Osteocalcin ,biology.protein ,business ,bone turnover biomarkers - Abstract
Purpose/Introduction: Osteoporosis (OP) and cardiovascular (CV) disease emerge as closely related conditions, showing common risk factors and/or pathophysiological mechanisms. The aim of this study was to evaluate the association between bone health markers (BHM) and individual CV risk factors and overall CV risk (FRAMINGHAM-FRS, and PROCAM scores) in a general adult population. Methods: In 103 subjects (21 males; age: 56 ± 12 years), vitamin D (25(OH)D), osteocalcin (OC), bone alkaline phospatase (BALP), procollagen I aminoterminal propeptide (P1NP), CTx-telopeptide, as well clinical history and life style were evaluated. Results: Aging (p < 0.001) and glycemia (p < 0.05) emerged as independent 25(OH)D predictors. Aging (p < 0.001), male sex (p < 0.05), and obesity (p < 0.05) represented independent OC determinants. Aging (p < 0.05) was the only independent BALP determinant. After multivariate adjustment, low 25(OH)D (75th percentile-16.6 ng/mL) (6.7 (1.9–23.8) p < 0.01) were found to be significant FRS predictors, while subjects with elevated OC and/or BALP (>75th percentile-9.8 μg/L) showed a higher CV risk as estimated by PROCAM (3.6 (1.2–10.7) p < 0.05). CTx and P1NP did not significantly correlate with CV risk factors or scores. Conclusion: As we go further into bone and CV physiology, it is evident that a close relationship exists between these diseases. Further studies are needed to investigate mechanisms by which bone turnover markers are related to metabolic risk and could modulate CV risk. This knowledge may help to develop possible multiple-purpose strategies for both CV disease and OP prevention and treatment.
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- 2017
38. P444Effect of sex on reverse remodelling in chronic systolic heart failure
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Vincenzo Castiglione, E Pasanisi, Giuseppe Vergaro, Silvia Maffei, V Chubuchny, A Barison, Alberto Aimo, Claudio Passino, James L. Januzzi, Michele Emdin, Alberto Giannoni, Roberta Poletti, and C Petersen
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,medicine ,Chronic systolic heart failure ,Cardiology and Cardiovascular Medicine ,business - Published
- 2017
39. Effect of Sex on Reverse Remodeling in Chronic Systolic Heart Failure
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Alberto Aimo, Emilio Pasanisi, Andrea Barison, Alberto Giannoni, Silvia Maffei, Christina Petersen, V Chubuchny, Giuseppe Vergaro, Michele Emdin, James L. Januzzi, Claudio Passino, Roberta Poletti, and Vincenzo Castiglione
- Subjects
Male ,medicine.medical_specialty ,Bundle-Branch Block ,Myocardial Ischemia ,heart failure ,030204 cardiovascular system & hematology ,reverse remodeling ,sex ,Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Sex Factors ,Interquartile range ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Reverse remodeling ,Ventricular remodeling ,Aged ,Proportional Hazards Models ,Ejection fraction ,Bundle branch block ,Ventricular Remodeling ,business.industry ,Proportional hazards model ,Stroke Volume ,Stroke volume ,Middle Aged ,medicine.disease ,Prognosis ,Echocardiography ,Heart failure ,Chronic Disease ,Cardiology ,Female ,business ,Heart Failure, Systolic - Abstract
This study sought to investigate sex-related differences in reverse remodeling (RR).RR, that is, the recovery from left ventricular (LV) dilation and dysfunction in response to treatment for heart failure (HF), is associated with improved prognosis.Data from patients with stable systolic HF (LV ejection fraction [LVEF] of 50%) undergoing 2 transthoracic echocardiograms within 12 ± 2 months were analyzed. Reverse remodeling was defined as a ≥15% reduction in LV end-systolic volume index.A total of 927 patients were evaluated (68 ± 12 years; median LVEF = 35% [interquartile range: 30% to 43%]; 27% women). Ischemic HF was less often encountered in women (33% vs. 60%, respectively; p 0.001), whereas most characteristics did not differ with regard to sex. Women showed a higher incidence of RR (41% vs. 27%, respectively; p 0.001), despite similar baseline LV volume and function. RR was more frequent among women in the subgroups with either ischemic or nonischemic HF, as well as in all categories of systolic dysfunction (LVEF ≤35% or 35%, according to current indication for device implantation, and LVEF 40% or 40% to 50% according to the definition of HF with reduced or mid-range EF). In the whole population, female sex was an independent predictor of RR (hazard ratio: 1.54; 95% confidence interval: 1.11 to 2.14; p = 0.011), together with cause of HF, disease duration, and left bundle branch block. Female sex was again an independent predictor of RR in all LVEF categories.Reverse remodeling is more frequent among women, regardless of cause and severity of LV dysfunction. Female sex is an independent predictor of RR in all categories of LV systolic dysfunction.
- Published
- 2017
40. Evaluation of the Effects of the Metha® Short Stem on Periprosthetic Bone Remodelling in Total Hip Arthroplasties: Results at 48 Months
- Author
-
Paolo D, Parchi, Gianluca, Ciapini, Iacopo, Castellini, Claudia, Mannucci, Anna Maria, Nucci, Nicola, Piolanti, Silvia, Maffei, and Michele, Lisanti
- Subjects
Adult ,Male ,Bone Density ,Arthroplasty, Replacement, Hip ,Humans ,Female ,Bone Remodeling ,Femur ,Hip Prosthesis ,Middle Aged ,Prosthesis Design - Abstract
Total hip arthroplasty is one of the most performed procedures in orthopaedic surgery. Implantation of a prosthesis determines changes in the distribution of loads on the host bone, and this phenomenon, known as stress shielding, is related to the biomechanical characteristics of the implant. Usually stress shielding involves the proximal portion of the femur by reducing the mechanical strength and ability to withstand the transmitted loads. The aim of our study is to demonstrate how the use of a short hip stem reduces the stress shielding phenomenon to the proximal femur.The study analyzed 20 patients undergoing hip prosthesis surgery with a short stem (Metha, B. Braun Medical, Inc., Bethlehem, Pennsylvania) at the Ist Orthopaedic Division of Pisa University (between December 2008 and January 2010). Each patient was subjected to analysis of periprosthetic bone mineral density by a bone densitometry (dual emission X-ray absorptiometry [DEXA] with the metal removal software) at 0, 6, 12, 18, 24, and 36 months, following a protocol based on the evaluation of the changes of bone density in the seven Gruen zones.We recorded minimal changes in bone mineral density (BMD) at the level of the greater trochanter (-1.44%) and at the level of the calcar (-3.7%). BMD increased significantly after four years at the level of the lateral distal regions (R2 +9.6% - R3 + 12.4%) and at the level of the distal medial regions (R5 + 8.2% - R6 + 13.1%). We compared the results obtained with the literature data at 12 and 24 months with the same stem (Metha). At 12 months follow up, we did not see a significant difference between our data and the data published in the literature. However, after 48 months of follow-up, we recorded significant differences in the curves of periprosthetic bone reabsorption at the level of the greater trochanter (Zone 1) and at the level of the calcar (Zone 7).The data obtained from our study are in agreement with other studies in the literature, which demonstrates how the use of short stems preserves the metaphyseal bone stock at the level of the proximal femur, reducing the stress shielding phenomenon. From our data, obtained at 24 months and confirmed at 36, stress shielding seems to minimally occur at the level of the calcar. At the level of the great trochanter, we saw a good load distribution that maintained the baseline BMD; these data are in opposition to the literature data that showed a high increase of BMD at the level of the calcar (+12.9%) and a decrease at the level of the great trochanter. From the analysis of the radiographic images of our cases, and of the cases published with the same stem, these differences in load transfer encountered between the great trochanter and the calcar seems to be related to the level of the femoral neck osteotomy and the consequent stem position (varus/valgus).We conclude that the amount of periprostetic bone reabsorption around the Methastem seems to be strictly related to the surgical technique and the final implant position.
- Published
- 2017
41. Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases?
- Author
-
Angelo Cagnacci, Marco Gambacciani, Nicoletta Biglia, Stefano Lello, R. E. Nappi, and Silvia Maffei
- Subjects
Adult ,Menopause ,biomarker ,cardiovascular disease ,chronic disease ,hot flushes ,vasomotor symptoms ,medicine.medical_specialty ,Bone density ,Osteoporosis ,Sweating ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Bone Density ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Cognitive decline ,Osteoporosis, Postmenopausal ,Aged ,030219 obstetrics & reproductive medicine ,Vasomotor ,business.industry ,Obstetrics and Gynecology ,Estrogens ,General Medicine ,Middle Aged ,medicine.disease ,Vasomotor System ,Chronic disease ,Cardiovascular Diseases ,Hot Flashes ,Physical therapy ,Biomarker (medicine) ,Female ,Cognition Disorders ,business ,Biomarkers - Abstract
Menopausal disorders may include shorter-term symptoms, such as hot flushes and night sweats (vasomotor symptoms, VMS) and longer-term chronic conditions such as cardiovascular disease (CVD), osteoporosis, and cognitive impairment. Initially, no clear link between the shorter-term symptoms and longer-term chronic conditions was evident and these disorders seemed to occur independently from each other. However, there is a growing body of evidence demonstrating that VMS may be a biomarker for chronic disease. In this review, the association between VMS and a range of chronic postmenopausal conditions including CVD, osteoporosis, and cognitive decline is discussed. Prevention of CVD in women, as for men, should be started early, and effective management of chronic disease in postmenopausal women has to start with the awareness that VMS during menopause are harbingers of things to come and should be treated accordingly.
- Published
- 2017
42. Atrial chamber remodelling in healthy pre-adolescent athletes engaged in endurance sports: A study with a longitudinal design. The CHILD study
- Author
-
Silvia Maffei, Marco Bonifazi, Michael Y. Henein, Marco Solari, Sergio Mondillo, Francesca Anselmi, Marta Focardi, and Flavio D'Ascenzi
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Athlete's heart ,Pre adolescents ,Echocardiography, Three-Dimensional ,3-dimensional echocardiography ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Atrial strain ,medicine ,athlete's heart ,Training ,Humans ,Heart Atria ,Child ,Swimming ,3 dimensional echocardiography ,Exercise Tolerance ,biology ,Athletes ,business.industry ,Medicine (all) ,Speckle-tracking echocardiography ,030229 sport sciences ,Atrial Remodeling ,biology.organism_classification ,Adaptation, Physiological ,medicine.anatomical_structure ,Echocardiography ,Physical therapy ,Cardiology and Cardiovascular Medicine ,Ventricular Function, Right ,Right atrium ,sense organs ,business ,Heart atrium - Abstract
Previous studies investigated the exercise-induced adaptation of left (LA) and right atrium (RA) in adults, but little is known about respective changes in the growing heart of children. We aimed to longitudinally investigate the effects of endurance training on biatrial remodelling in preadolescent athletes.Ninety-four children (57 endurance athletes, 37 sedentary controls; mean age 10.8±0.2 and 10.2±0.2years, respectively) were evaluated at baseline and after 5months by ECG and by two-dimensional, three-dimensional (3D) and speckle-tracking echocardiography. Athletes were trained at least 10h/week. The resting heart rate was lower in athletes (p=0.046) and decreased further after training (p0.0001). Neither athletes nor controls had ECG evidence for LA or RA enlargement. At baseline, indexed LA volumes did not differ between groups (p=0.14) but indexed RA dimensions were larger in athletes (p=0.007). After 5months, indexed LA volumes increased in athletes but not in controls (p0.0001, p=0.29; respectively) while indexed RA volumes increased in both groups (p0.0001, p=0.018; respectively). At the same time, slight differences in biatrial reservoir and contractile function were found either in athletes, as demonstrated by speckle-tracking echocardiography, but 3D-derived LA and RA ejection fraction remained stable in both groups.Endurance training influences the growing heart of preadolescent athletes with an additive increase in biatrial size, suggesting that morphological adaptations can occur also in the early phases of the sports career. Training-induced remodelling was associated with a preserved biatrial function, supporting the hypothesis of a physiological remodelling.
- Published
- 2016
43. Effects of levosimendan without loading dose on systolic and diastolic function in patients with end-stage heart failure
- Author
-
Elisabetta Palmerini, Sergio Mondillo, Stefano Lunghetti, Rossella Urselli, Marta Focardi, Silvia Maffei, Roberto Favilli, and Elisa Guarino
- Subjects
Male ,Inotrope ,medicine.medical_specialty ,Cardiotonic Agents ,Systole ,Levosimendan ,medicine.drug_class ,severe heart failure ,diastolic function ,Heart Failure Therapy ,Diastole ,Hemodynamics ,Severity of Illness Index ,Loading dose ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,Simendan ,Aged ,Ultrasonography ,Heart Failure ,Chi-Square Distribution ,Ejection fraction ,business.industry ,Hydrazones ,General Medicine ,Middle Aged ,medicine.disease ,Pyridazines ,Treatment Outcome ,Italy ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,medicine.drug - Abstract
Background: Levosimendan (L) is used in clinical practice for the treatment of severe heart failure (HF); it has inotropic and vasodilatory effects, without increasing myocardial oxygen consumption. In acute HF, levosimendan improves hemodynamic parameters; previous stu- dies have demonstrated that it has favorable effects on left ventricular (LV) diastolic function. The aim of our study was to evaluate the effect of on LV long-axis function that represents the earlier marker of diastolic dysfunction. Methods: We enrolled 41 patients (age 62 ± 12 years) admitted to our Department for acute HF, NYHA class IV and severe LV dysfunction. Twenty-six patients were treated with L (0.1 µg/kg/min ev for 24 h without loading dose) and 15 patients were treated with standard therapy (C). We evaluated clinical, blood exams and echocardiographic parameters at baseline and one week after L or C treatment. Results: Baseline demographic, clinical and biochemical data were similar in both groups. After one week, the L group had shown a significant improvement in NYHA class and a redu- ction of pro-B-type natriuretic peptide (pro-BNP). In echocardiographic study, we observed an improvement in LV longitudinal function (p < 0.05) and LV ejection fraction (p < 0.05) with a reduction of E/E ' (p < 0.05) in the L group. We divided the L group into ischemic and non- -ischemic patients and we demonstrated a significant increase in systolic function in the for- mer. No differences were found between subgroups in diastolic function. Conclusions: L therapy, without loading dose, improves NYHA class and ventricular func- tion in patients with acute HF; we believe that these prolonged hemodynamic effects are due to active metabolities of L. (Cardiol J 2011; 18, 5: 532-537)
- Published
- 2011
44. Hormone replacement therapy and cardioprotection: a new dawn? A statement of the Study Group on Cardiovascular Disease in Women of the Italian Society of Cardiology on hormone replacement therapy in postmenopausal women
- Author
-
Marco Gambacciani, Giuseppe M.C. Rosano, Cristina Vassalle, Marco Stramba-Badiale, Silvia Maffei, Cristiana Vitale, Maria Grazia Andreassi, and Giuseppe Mercuro
- Subjects
medicine.medical_specialty ,Heart Diseases ,medicine.drug_class ,Population ,Disease ,Risk Assessment ,Risk Factors ,Neoplasms ,Internal medicine ,Epidemiology ,medicine ,Humans ,Hormone replacement therapy ,education ,Randomized Controlled Trials as Topic ,Cause of death ,Gynecology ,education.field_of_study ,Evidence-Based Medicine ,business.industry ,Patient Selection ,Estrogen Replacement Therapy ,Age Factors ,General Medicine ,Middle Aged ,medicine.disease ,Postmenopause ,Menopause ,Italy ,Estrogen ,Women's Health ,Female ,Progestins ,Cardiology and Cardiovascular Medicine ,business ,Progestin - Abstract
Cardiovascular disease is the leading cause of death in women in Western countries. Despite preventive strategies, in the past decades the incidence of cardiovascular events has shown a decline in men but a rise in women, matching the growth of the population of postmenopausal women. Several epidemiological findings suggest the causative pathophysiological role of ovarian hormone deficiency in the development of cardiovascular disease in women. Observational and randomized studies have suggested that hormone replacement therapy in early postmenopause could be beneficial from a cardiovascular point of view. Conversely, aging, time since menopause and presence of cardiovascular risk factors or cardiovascular disease may decrease its efficacy and increase the risk of cardiovascular events. It is plausible that the unfavorable effects of the estrogen/progestin combination used in the randomized studies are not related to the hormone preparation per se but rather to the use of hormones in the less receptive group of women, older and with cardiovascular risk factors. Clinical judgment, choice of the right dose and estrogen/progestin combination are of pivotal importance to maximize the beneficial effect of estrogen replacement therapy/hormone replacement therapy, especially if given within a reasonable time after the menopause to women who need the therapy for the relief of menopausal symptoms.
- Published
- 2009
45. The ovarian cycle as a factor of variability in the laboratory screening for primary aldosteronism in women
- Author
-
Enza Fommei, Andrea Ripoli, A. Iervasi, Sergio Ghione, S. Turchi, Silvia Maffei, and P Di Cecco
- Subjects
Adult ,medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Luteal phase ,Cohort Studies ,chemistry.chemical_compound ,Primary aldosteronism ,Internal medicine ,Hyperaldosteronism ,Renin ,Follicular phase ,Blood plasma ,Internal Medicine ,medicine ,Humans ,False Positive Reactions ,Gonadal Steroid Hormones ,Aldosterone ,Menstrual Cycle ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Steroid hormone ,Endocrinology ,chemistry ,Mineralocorticoid ,Hypertension ,Female ,business ,Hormone - Abstract
Primary aldosteronism is increasingly investigated in hypertension being associated with an elevated cardiovascular risk. Aldosterone has been reported to increase in the luteal phase in normal women but to our knowledge the influence of the ovarian cycle on the first screening for primary aldosteronism (that is, on the levels of plasma aldosterone and its relationship to PRA levels) was never investigated. We measured hormonal levels during one cycle in 26 low-renin mild hypertensive outpatients. LH, FSH, 17 beta-estradiol, progesterone, aldosterone and PRA were assayed at the seventh, fourteenth, twenty-first and twenty-eighth days of the cycle after 30 min of recumbency. Aldosterone and PRA increased from the seventh (follicular phase) to twenty-first day (luteal phase) from 11.2 to 17.8 ng 100 ml(-1) and from 0.23 to 0.35 ng ml(-1) h(-1), respectively (both P=0.004) The proportion of patients with aldosterone15 ng 100 ml(-1) significantly increased from the follicular to the luteal phase, (8/26 vs 19/25, P=0.018); a similar increase was found for Aldosterone-PRA Ratio30 combined with either a minimum PRA value of 0.5 ng ml(-1) h(-1) or aldosterone15 ng 100 ml(-1) (7/26 vs 16/25 and 7/26 vs 17/25 respectively, P0.05). Aldosterone was positively related to PRA and progesterone. Higher aldosterone levels may be frequently encountered in the second part of the ovarian cycle in low-renin hypertensive women. This variability appears to be an important factor to be taken into account in the first-step laboratory screening for primary aldosteronism and should be considered in the process of standardization of the diagnostic work-up for this disease.
- Published
- 2008
46. Electromagnetic fields produced by incubators influence heart rate variability in newborns
- Author
-
Silvia Maffei, Carlo Valerio Bellieni, Iole Pinto, Maurizio Acampa, Nicola Stacchini, Marianna Maffei, sara perrone, and Giuseppe Buonocore
- Subjects
Male ,Incubators, Infant ,Pediatrics ,medicine.medical_specialty ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,Incubator ,Environmental Exposure ,General Medicine ,Audiology ,Electromagnetic Fields ,Heart Rate ,Intensive Care Units, Neonatal ,Pediatrics, Perinatology and Child Health ,Humans ,Heart rate variability ,Medicine ,Female ,Autonomous nervous system ,business - Abstract
Incubators are largely used to preserve preterm and sick babies from postnatal stressors, but their motors produce high electromagnetic fields (EMFs). Newborns are chronically exposed to these EMFs, but no studies about their effects on the fragile developing neonatal structure exist. Aim: To verify whether the exposure to incubator motor electric power may alter autonomous nervous system activity in newborns. Material and methods: We studied hear rate variability (HRV) in 43 newborns while in incubators. The study group was composed of 27 newborns whose HRV was studied throughout three 5-minute periods: with incubator motor on, off, and on again, respectively. Mean HRV values obtained during each period were compared. The control group was composed of 16 newborns with constantly unrecordable EMF and exposed to changes in background noise, similar to those provoked by the incubator motor. Results: Mean total power and HF (High frequency) component of HRV increased significantly (from 87.1±76.2 msec2 to 183.6±168.5 msec2) and mean LF/HF (Low/High frequency) ratio decreased significantly (from 2.0±0.5 to 1.5±0.6) when the incubator motor was turned off. Basal values (HF =107.1±118.1msec2 and LF/HF = 1.9±0.6) were restored when incubators were turned on again. The LF spectral component of HRV showed a statistically significant change only in the second phase of the experiment. Changes in background noise did not provoke any significant change in HRV. Conclusion: EMFs produced by incubators influence newborns9 HRV, showing an influence on their autonomous nervous system. More research is needed to assess possible long-term consequences, since premature newborns may be exposed to these high EMFs for months.
- Published
- 2007
47. Bone Remodeling Biomarkers: New Actors on the Old Cardiovascular Stage
- Author
-
Giorgio Iervasi, Cristina Vassalle, and Silvia Maffei
- Subjects
Oncology ,medicine.medical_specialty ,Pathology ,business.industry ,Internal medicine ,Osteoporosis ,medicine ,Stage (cooking) ,medicine.disease ,business ,Bone remodeling - Published
- 2015
48. EVALUATION OF PERIPROSTHETIC BONE RESORPTION SECONDARY TO FIRST TOTAL HIP REPLACEMENT WITH METHA® SHORT HIP STEM: FOLLOW-UP EXAMINATION RESULTS AT 48 MONTHS
- Author
-
Ciapini, Gianluca, Parchi, PAOLO DOMENICO, Claudia, Mannucci, Castellini, Iacopo, Piolanti, Nicola, Andreani, Lorenzo, Silvia, Maffei, and Lisanti, Michele
- Published
- 2015
49. DENSITOMETRIC EVALUATION OF PERIPROSTHETIC BONE RESORPTION AFTER SURGICAL PLACEMENT OF ACCOLADE I TMZF HIP STEM AT 36 MONTHS
- Author
-
Parchi, PAOLO DOMENICO, Ciapini, Gianluca, Claudia, Mannucci, Castellini, Iacopo, Marchetti, Stefano, Silvia, Maffei, and Lisanti, Michele
- Published
- 2015
50. Salute della donna & esercizio fisico
- Author
-
Lucia, Cugusi, Donataccio, Maria Pia, Pasqualotto, Silvia, Francesca, Vassanelli, Christian, Cadeddu, Silvia, Maffei, Sabina, Gallina, and Giuseppe, Mercuro
- Subjects
attività fisica ,salute cardiovascolare ,donna ,salute cardiovascolare, donna, attività fisica - Published
- 2015
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